Putting this important in right order (to unroll)

This is a highly relevant study from Japan on #Dysautonomia, #gAchR antibodies and #FND! I'll explain why it's important and what it means in clinical terms. 1/ #MedTwitter #NeuroTwitter @Dysautonomia Intl. frontiersin.org/articles/10.33…

What the study found: Out of 59 patients who qualified for #FND diagnosis by DSMV criteria, 88% had autonomic symptoms!!! 27% were positive for ganglionic acetylcholine receptor antibody (gAchR Ab) via LIPS assay. 50% had #POTS. 50% had orthostatic hypotension. 2/

Why is this important? Our patients are often misdiagnosed with #FND, and this study proves that. When #FND is diagnosed, treatment is psychotherapy & physical therapy, which is not a treatment for #Dysautonomia. We MUST identify and treat #Dysautonomia symptoms. 3/

Perhaps FND society and DSMV should rethink their diagnostic criteria for #FND if 88% of their patients have #Dysautonomia. #Dysautonomia is not #FND. #Autoimmunity and what to do about it in patients with #Dysautonomia should be a priority #research topic. End 4/4

What I didn't mention, but probably should have is that 9 patients who qualified for FND diagnosis were excluded because of concomitant neuroimmune disorders, like Sjogren's, myasthenia and CIDP... This too is very important because it's 13% of their FND cohort!